ABSTRACT Given the success, efficiency, and integration achieved in our first cycle, we will retain the previous structure of our Administrative Core (Core A), which will provide the essential administrative management and scientific leadership to facilitate and ensure productivity and integration of effort between all 5 proposed projects and 2 additional cores for the proposed Program Project renewal. We propose the following aims: (1) to provide overall leadership and organization that will ensure regular, ongoing, coordinated scientific interaction, planning, learning and feedback between all cores and projects, and effective and efficient use of shared resources; (2) to monitor timely progress and effectiveness of operations of all cores and projects, jointly holding investigators accountable for products expected on those timelines, and requiring any course corrections, as needed; (3) to convene meetings with the Safety Officer on a quarterly basis, and coordinate preparation of all necessary safety monitoring materials across all projects and cores; and (4) to conduct all reporting activities required by the National Institute on Aging, our Scientific Advisory Board, our safety monitoring process, and institutional review boards. The organizational structure of the Core will include a central Executive Committee, the main decision-making and policy group; Operations Committee, in charge of day-to-day operations; Scientific Working Group, for scientific advancement and productivity in abstracts and papers; Publications Committee, providing oversight and approval of publication requests; Biorepository/Database Committee, providing oversight and approval of requests for data sharing and use of Biorepository specimens; Fiscal Management Committee, tracking all budgets and subcontracts to maintain fiscal accountability; and the Scientific Advisory Board, meeting annually to evaluate and guide the progress of the Program Project. The Core has already demonstrated its success in managing a complex program across multiple sites and holding the leaders accountable for timelines and productivity. The Core established the central infrastructure and successfully enrolled a large and complex cohort of over 560 surgical patients, with high quality data. Demonstrated productivity has included 3 Advisory Board meetings, 5 Annual Scientific Symposia, 73 published manuscripts, an additional 2 publications under review, >90 conference presentations, and >9 related grants and supplements. By bringing investigators together for regular meetings and scientific symposia, and leveraging resources across projects, Core A will be able to ensure productive interactions between investigators, explore cross-linking hypotheses between projects, and create a whole that is greater than the sum of its parts. Importantly, our streamlined approach with efficient centralized enrollment and collection of the primary data and sharing of Core resources, augmented with specialized data from individual projects, permits our expansion to 5 projects. This successful Core with established infrastructure and procedures provides a strong foundation to ensure the success of the Delirium Program Project renewal.